The World Health Organization oral rehydration solution in US pediatric practice - A randomized trial to evaluate parent satisfaction

Background: The World Health Organization's effective, inexpensive oral reh ydration solution (WHO-ORS) is used worldwide, but rarely by US practitione rs because, in part, of concerns about parent satisfaction. Objective: To compare caretaker satisfaction with the WHO-ORS, a packet-bas ed solution requiring preparation, with satisfaction with a commercially pr epared oral rehydration solution (C-ORS), (Pedialyte; Ross Nutritionals, Co lumbus, Ohio). Design and Methods: Randomized controlled trial in an urban pediatric clini c and a suburban family medicine clinic. Children aged 3 to 47 months treat ed as outpatients for diarrhea were randomized to receive either WHO-ORS or C-ORS. After 48 hours of use, caretakers completed a telephone interview m easuring satisfaction with aspects of the solution. Results: Of 97 families enrolled, 91 (94%) were available for follow-up int erviews. The WHO-ORS and C-ORS groups were comparable at baseline in all re spects, except that slightly more caretakers in the latter group had used t he C-ORS for the current illness before study enrollment (P = .06). Caretak ers ill the WHO-ORS group had higher overall satisfaction, satisfaction wit h cost, willingness to purchase in the future, and to recommend use (P < .0 01 for all). Differences remained significant after controlling fur prior u se of the C-ORS. There was no difference in satisfaction with ease of admin istration (P = .90). appearance (P = .20), and effectiveness (P = .80). No adverse effects attributable to either study solution occurred. Conclusions: Caretakers who prepared and used the WHO-ORS were more satisfi ed with their solution than a comparable group who administered C-ORS. Fear of parental dissatisfaction need not be a barrier to use of die WHO-ORS in the United States.